ARE THERE OTHER OPTIONS FOR MY BIPOLAR II DISORDER? 
Ask The Doctor Dr. Leland Heller Biological Unhappiness 
ARE THERE OTHER OPTIONS FOR MY BIPOLAR II DISORDER? 
Question: Hi Doc, I was diagnosed with Bipolar Type 2. I am on Depakote and Seroquel and have had a adverse reaction to Depakote (Divalproex). I have been on it for 2 months now and I am having a lot of aggression and anger. So I Don’t know if it’s helping the mania. Also this depression I am going into is worse than any low I had before Depakote. This is very disappointing because I couldn’t use lithium because of the side effects. The depression and anxiety have gotten worse what do you think I should do besides an SSRI which isn’t an option. Isn’t there any other better mood stabilizers which help depression and anxiety. Dr. Heller’s Answer: For plain bipolar II without other comorbid conditions there are many different options including: A) Mood stabilizers:
1) Tegretol (carbamazepine) 2) Lamictal (lamotrigine) 3) Topamax (topiramate)
B) Antipsychotic medications:
1) Abilify (aripiprazole) – which doesn’t cause weight gain and the one I prefer to prescribe for long term use (when necessary) 2) Zyprexa (olanzapine) – the most powerful and can cause serious weight gain 3) Risperdal (risperidone) – powerful and also causes weight gain 4) Seroquel (quetiapine) – sedating and can cause the “Seroquel munchies” 5) Geodon (ziprasidone) – in my experience not that effective, but some practitioners believe it’s an excellent choice with little weight gain
Most individuals have more going on than just bipolar, and for these individuals the mood stabilizer and/or antipsychotic medication are insufficient. Common “co-morbid” conditions include ADHD, BPD (borderline personality disorder), obsessive compulsive disorders, generalized anxiety disorder and panic. My screening test should be helpful in this regard:http://pks.947.myftpupload.com/screen.htm The treatment plan depends on the diagnoses present. . 
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